Dental

Colquitt County Schools offers two dental plans through MetLife: the Low Plan and the High Plan. Both plan options include preventive care at 100% (no deductible) and two cleanings per calendar year. The Low Plan has the lowest premiums and lowest annual maximum benefit, but only includes coverage for preventive and basic restorative services. The High Plan has higher premiums and a higher annual maximum, and includes coverage for orthodontia for children and major restorative services.  


 

Premium Information

Important Documents

To reduce your out-of-pocket costs and prevent balance billing, you are encouraged to use in-network dentists. Visit www.metlife.com/ dental to locate participating dentists. Select “PDP Plus” dental network. You can also download the mobile app to view plan information, find a provider, or view your ID card. Please refer to the Benefits Summaries for complete details.

 

Below is a brief summary of your annual deductible and co-insurance costs. Please refer to the complete Benefit Summaries for additional details. 

MetLife PDP Plus Coverage Low Plan High Plan
Deductible
$50 individual | $150 Family $50 individual | $150 Family
Type A - Preventive Services (Deductible Waived):
Cleanings and exam
Plan pays 100% Plan pays 100%
Type B - Basic Services (After Deductible):
Fillings, simple extractions, X-rays, and more
Plan pays 60% after deductible Plan pays 80% after deductible
Type C - Major Services (After Deductible):
Oral surgery, implants, crowns, and more
Not Covered Plan pays 50% after deductible
Type D - Orthodontia; up to age 26 (After Deductible):
Not Covered Plan pays 50% after deductible
Orthodontia Lifetime Maximum
N/A $1,000 per person
Annual Maximum (per person)
$750 per person $1,100 per person

Important Notes


  • Orthodontia is excluded for adults and only available for dependent children up to age 26, on the high plan. The low plan does not include orthodontia coverage.

  • Deductible (waived for preventive); differing annual maximums depending on plan

  • Members utilizing MetLife participating dentists will enjoy discounted dental fees in addition to protection from balance billing for charges above the dentist’s maximum allowable charges. Members utilizing non-participating dentists will have the same benefits but may be subject to balance billing.

Claims Process


In-Network

  • Participating MetLife dentists file the claim and accept payment from MetLife
  • Employees should not need to pay at the time of service for participating providers

 

Out-of-Network

  • For out-of-network dentists, if the dentist does not agree to file the claim as out-of-network with MetLife, employee pays at the time of service and files a claim for reimbursement
  • The plan reimburses at the 90th percent of Reasonable and Customary (R&C) for out-of-network providers.  Charges by out-of-network providers that exceed R&C are the member’s financial responsibility. (Member pays the difference between the actual charge and the plan’s R&C reimbursement level.)

Required Notices for Enrollment


Please refer to the Resources page for MetLife Required Notices for Enrollment